Jews and Hereditary Cancer

BRCA mutations, linked to an increased risk of breast cancer, male breast cancer, ovarian cancer, prostate cancer, pancreatic cancer, and melanoma, occur in Ashkenazi Jews at rates more than ten times higher than in the general population. About 1 in 40 Ashkenazi Jews carry a BRCA mutation.

Statement on BRCA and Genetic Screening

Revised: January 20, 2015

The Center for Jewish Genetics Recommends Genetic Counseling for All Persons Considering BRCA Testing

In the fall of 2014, studies published in The Journal of the American Medical Association, the Proceedings of the National Academy of Sciences of the United States of America, and The Journal of the National Cancer Institute recommended that women over the age of 30 get tested for mutations in the BRCA1 and BRCA2 genes. Mutations to these two genes increase the risk of contracting female breast and ovarian cancer, as well as other types of cancer. Further, these three studies recommended testing regardless of family history of breast or ovarian cancer.

It is well-documented that Ashkenazi Jews have a much greater risk for carrying mutations in the BRCA1 and BRCA2 genes. In fact, one in 40 individuals of Ashkenazi descent is a carrier of a BRCA mutation compared to one in 400 individuals in the general population.

Whether you have decided to get BRCA testing or are just thinking about it, the first step is to "do your homework." You should know what to expect and what’s involved in the testing process to make an informed decision about what’s right for you.

The Center for Jewish Genetics, along with other nationally renowned institutions such as the National Society of Genetic Counselors, recommends that you:

  • Meet with a genetic counselor, or with a physician or health care provider involved with cancer treatment and prevention.
  • Discuss with that professional your family history of breast and ovarian (and other) cancer, what testing results can and cannot reveal, and the health management options that exist in the event you are tested and it reveals you are a carrier of a BRCA mutation.

We can help you get started. While the Center for Jewish Genetics has screening and education programs for 19 Ashkenazi Jewish genetic disorders (with the option of an expanded panel of 80+ conditions), we do not offer genetic testing for BRCA. However, the Center will help identify centers near you so that you may receive the appropriate testing. Please feel free to contact our genetic counselor with any questions or concerns.

(Note: The Norton & Elaine Sarnoff Center for Jewish Genetics expanded its screening panel in September 2017. It currently screens for more than 190 recessive conditions, including more than 50 that are more common among Ashkenazi and Sephardic Jews.)

Facts About BRCA Mutations

Approximately 5-10% of breast cancer and 15% of ovarian cancer is hereditary. The two genes that cause the vast majority of hereditary breast and ovarian cancer are called BRCA1 and BRCA2. These are tumor suppressor genes that normally control cell growth and cell death. We all carry these genes, but people who carry mutated forms of the BRCA1 and BRCA2 genes have a predisposition to certain types of cancer.  Women and men who carry a mutation, regardless of whether they develop cancer, have a 50% chance of passing the mutation on to the next generation.

  • Approximately 1 in 40 individuals of Ashkenazi Jewish descent carries a BRCA mutation. Individuals who carry a BRCA1 or BRCA2 mutation or those with a strong family history are considered "high risk." The Ashkenazi carrier rate is at least 10 times higher than for the general population.
  • In addition to breast and ovarian cancer, BRCA1 and BRCA2 mutations also increase the risk of male breast cancer, prostate cancer, pancreatic cancer and melanoma. Cancers in people with hereditary risk tend to develop at younger ages compared to cancers in the general population, although they may develop at any age. Genetic counseling and testing can help individuals be proactive about their risk and learn how to prevent and detect cancer at earlier stages.

    Surveillance and management for BRCA1 and BRCA2 mutation carriers:

    Active surveillance and management – watching for warning signs and staying on top of your health – as well as lifestyle modifications, can significantly decrease one’s risk. Your personal health and family history will help determine at what age and how frequently to utilize these strategies. Please consult your physician for individual recommendations.

    General Recommendations May Include:

    • Breast self-exams
    • Clinical breast exams and pelvic exams
    • Mammography
    • Breast MRI, which can detect early breast cancers that are undetected on a mammogram and not felt by a physician
    • Transvaginal ultrasound and CA-125 blood serum level, to screen for ovarian cancer (note: this screening has limitations and can miss cancers during the early, most curable stages)
    • Chemoprevention medications to help prevent breast cancer, and oral contraceptives, to help prevent ovarian cancer
    • Preventive breast surgery, along with a discussion of breast reconstruction
    • Preventive removal of the ovaries and fallopian tubes, along with a discussion of hormonal and non-hormonal management of menopausal symptoms and prevention of bone loss

    General Risk Reduction Strategies Include:

    • Maintaining a healthy diet high in fruits and vegetables and low in fat
    • Decreasing alcohol consumption and avoiding nicotine
    • Exercising regularly; your risk of breast cancer may be up to one-third lower with regular physical activity
    • Childbearing, tubal ligation (“having your tubes tied”) and the use of oral contraceptives have all been identified as possible protective factors against ovarian cancer (note: these are not as effective as preventive surgery). Breastfeeding is also a possible protective factor against both breast and ovarian cancer.

    Do You Know What's In Your Genes?

    What is the most valuable gift you can give to your family? The gift of good health! There are many health conditions that run in families. Knowing your family health history can alert you to the potential risk for a variety of genetic disorders . Be sure to check with your relatives for warning signs and assess your risk for hereditary cancers!

    Did you know: Ashkenazi Jews are 10 TIMES more likely to have BRCA mutations, which significantly increases lifetime risks for hereditary cancers, so what does this heightened risk mean for you? Click here to learn more !